HERMES RYOITI HIGASHINO

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/49 - Laboratório de Protozoologia, Hospital das Clínicas, Faculdade de Medicina

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Autor: ANJOS, Beatriz Barbosa × Autor e Coautores FMUSP-HC Normalizados: FERNANDA DE SOUZA SPADAO × Indexador: PubMed ×

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  • article 0 Citação(ões) na Scopus
    Colonization by Extended-Spectrum β-Lactamase-Producing Enterobacterales and Bacteremia in Hematopoietic Stem Cell Transplant Recipients
    (2024) GONCALVES, Luiza Arcas; ANJOS, Beatriz Barbosa; TAVARES, Bruno Melo; MARCHI, Ana Paula; CORTES, Marina Farrel; HIGASHINO, Hermes Ryoiti; MORAES, Bruna del Guerra de Carvalho; BAMPI, Jose Victor Bortolotto; PINHEIRO, Liliane Dantas; SPADAO, Fernanda de Souza; ROCHA, Vanderson; GUIMARAES, Thais; COSTA, Silvia Figueiredo
    Background: Assessing the risk of multidrug-resistant colonization and infections is pivotal for optimizing empirical therapy in hematopoietic stem cell transplants (HSCTs). Limited data exist on extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) colonization in this population. This study aimed to assess whether ESBL-E colonization constitutes a risk factor for ESBL-E bloodstream infection (BSI) and to evaluate ESBL-E colonization in HSCT recipients. Methods: A retrospective analysis of ESBL-E colonization and BSI in HSCT patients was conducted from August 2019 to June 2022. Weekly swabs were collected and cultured on chromogenic selective media, with PCR identifying the beta-lactamase genes. Pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing (WGS) assessed the colonizing strains' similarities. Results: Of 222 evaluated HSCT patients, 59.45% were colonized by ESBL-E, with 48.4% at admission. The predominant beta-lactamase genes were blaTEM (52%) and blaSHV (20%). PFGE analysis did not reveal predominant clusters in 26 E. coli and 15 K. pneumoniae strains. WGS identified ST16 and ST11 as the predominant sequence types among K. pneumoniae. Thirty-three patients developed thirty-five Enterobacterales-BSIs, with nine being third-generation cephalosporin-resistant. No association was found between ESBL-E colonization and ESBL-BSI (p = 0.087). Conclusions: Although the patients presented a high colonization rate of ESBL-E upon admission, no association between colonization and infection were found. Thus, it seems that ESBL screening is not a useful strategy to assess risk factors and guide therapy for ESBL-BSI in HSCT-patients.